Other Therapies for Depression

Scott Olson, ND

The only true stand-alone CAM therapy for depression is St. John’s Wort. All other CAM therapies are typically considered adjuncts (additions) to other treatments. The following therapies are currently being studied to determine whether they benefit people with depression. These therapies are generally not harmful, but it unclear whether they are truly helpful. There is some limited research on the effectiveness of these therapies, but study results do not allow us to suggest them as stand-alone treatments for depression.

B-Vitamins

B-vitamins, especially B1 (thiamin), B6 (pyridoxine), B9 (folic acid), and B12 (cobalamin) have all been examined for their contribution to depression. These B-vitamins play many important roles in the body and are necessary to manufacture brain chemicals (GABA, Serotonin, Dopamine, and others) responsible for regulating mood.

Many studies on effectiveness of using B-vitamins for treating depression are promising. However, many more studies must be conducted before concluding that these vitamins are effective in treating all types of depression. Research suggests that the B-vitamins tend to work well for depression related to a deficiency state (such as with alcoholics, or other people with poor nutrition) or for depression associated with premenstrual syndrome.

B-vitamins enhance the effects of many of the standard treatments for depression. Trials of standard antidepressant medications combined with B-vitamins indicated that people recover from depression more rapidly and often with fewer side effects when taking this combination.

The B-vitamins are water-soluble (dissolvable in water) and are easily removed from the body in the urine. They are generally considered safe, with little to no side-effects. However, megadoses (very high doses) of B6 (pyridoxine) have been associated with liver inflammation and nerve damage. It is best to take a multivitamin that contains many B-vitamins (such as a multi-B vitamin combination) or a separate B-complex supplement. Follow the dosing instructions on the vitamin label or consult with your health care practitioner.

Homeopathy

Homeopathy is the use of very small amounts of substances (sometimes an infinitesimal amount of the active ingredient) for the treatment of disease. Homeopathy is based on the principle of analogy; that "like-treats-like". With this principle in mind, a homeopathic practitioner might give a homeopathic medication that would normally cause a fever to someone who has a fever already. The thought is that the body seeks a "balance" with a disease and if it is pushed further, then the body will push back. If someone who has a fever is "given more fever", the body will react by reducing the fever.

Homeopathy is very difficult to study due to the varied treatments that practitioners use across different patients. Most homeopathic remedies are individualized to the patient; therefore, 10 patients with depression might get 10 different remedies. While a few studies have shown that homeopathy can be used to treat depression, these studies were not large or well-designed.

The mechanisms by which homeopathy achieves treatment effects is unclear. Many scientists suggest that when homeopathy works, benefits are caused by the so-called placebo effect (patients taking inactive medications show symptom improvement because they think they are receiving active drugs). This has not been established definitively, however. Some clinical trials have shown that homeopathy works better than a placebo (medication without an active ingredient) for treating depression, but other studies have not shown this result. In any event, most homeopathic preparations are so diluted that there is very little chance that an active ingredient (in the conventional sense) is present.

While there are many self-help books on homeopathy, it is best to go to a practitioner and have them personalize a remedy for you. Because homeopathy uses such small amounts of substances, it can be said that homeopathy has no side effects or drug interactions.

Yoga

Similar to exercise, yoga has shown some promise as a treatment for depression. Many yoga practices incorporate deep breathing, stretching, and strengthening exercises along with a mild cardiovascular workout in a class atmosphere.

Yoga is difficult to study in a clinical setting because there are several different factors that can impact its effectiveness. For example, there are many different types of yoga (with varied levels of relaxation or activity), and individual levels of effort during classes may vary. In addition, only certain people are willing to try this form of exercise, so study results may not apply to every group of people who are depressed. There are a few studies that suggest that regular yoga sessions improve depressive symptoms, but their design makes it difficult to draw broad conclusions about the type of person who would benefit most from this therapy.

Yoga can be practiced at home, or you can find a class at a local community/recreation center, gym, or yoga studio. There are forms of yoga that incorporate slow stretching and others that are more active. If you are thinking of trying yoga, visit a class a few times to determine which teacher and style will best meet your needs.

Acupuncture

Acupuncture literally means 'needle piercing" and is the practice of inserting very fine needles into the skin to stimulate specific anatomic (body) points for therapeutic purposes. In addition to needles, acupuncturists can also use heat, pressure, friction, suction, or electromagnetic energy impulses to stimulate acupuncture points. Treatment is designed to to balance the movement of energy (called qi) in the body to restore health.

Acupuncture has been shown some promise as a treatment for depression. Once again, the varied treatments (how the needles are used) and selection bias (only certain types of people are willing to try acupuncture) affect research trials, making it difficult to determine if acupuncture is helpful for all types of people with with depression. Further study is required.

The specific course and duration of acupuncture treatment depends on the nature and severity of depressive symptoms. A typical course of treatment might involve ten to twelve weekly sessions.